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AHA ’ s Poll: A Mere 30% of Patients Discuss OTC Pain Relievers And Blood Pressure
Conclusion In closing, the heart of the matter is clear: talk is potent medicine. When it comes to OTC pain relievers, this conversation could be a lifeline for many. Yet, as it stands, too many are swallowing risks along with their pills, unbeknownst to the silent threat to their blood pressure. Wrapping up, it’s a shared journey towards health literacy. Amplifying dialogue can ignite a wave of well-informed choices for managing blood pressure. If the nation speaks up, listens, and learns, we could see a future where fewer hearts are under pressure. Read also: 75% Commit To Daily Blood Pressu...
Source: The EMT Spot - November 3, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: News Source Type: blogs

See this " NSTEMI " go unrecognized for what it really is, how it progresses, and what happens
Written by Nathanael Franks MD, reviewed by Meyers, Smith, Grauer, etc.A man in his 70s with past medical history of hypertension, dyslipidemia, CAD s/p left circumflex stent 2 years prior presented to the ED with worsening intermittent exertional chest pain relieved by rest. This episode of chest pain began 3 hours ago and was persistent even at rest.Triage ECG at Time = 0: Smith: I am suspicious for posterior OMI due to ST depression in V2 and V3Baseline EKG (several months prior):Smith: Now I am even more suspicious of posterior OMI, as the baseline ECG has normal ST elevation in V2 and V3ECG Interpretation:The tri...
Source: Dr. Smith's ECG Blog - November 3, 2023 Category: Cardiology Authors: Pendell Source Type: blogs

What do you think of this ECG that was texted to me?
This ECG was texted to me by a colleague.  I assumed it was from a patient with symptoms compatible with ACS/OMI.What do you think?There is sinus rhythm with RBBB and ST Elevation in V2 which is concordant with the QRS.  The ST segment in RBBB should be ST depression, discordant to the positive R ' -wave (i.e., opposite direction of the upright R ' -wave).  But we sometimes see this concordant STE even in non-ischemic ECGs:PseudoSTEMI and True ST elevation in Right Bundle Branch Block (RBBB). Don ' t miss case 4 at the bottom.This STE suggests OMI, but we have seen many cases like this th...
Source: Dr. Smith's ECG Blog - November 1, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs

Cannabis compounds in fracture pain relief and healing
In a recent study published in the Journal of Bone and Mineral Research, it was found that two compounds found in cannabis, cannabidiol, and cannabigerol, may not just ease the pain of fractures but also speed up fracture healing. The study, titled “Cannabidiol (CBD) and Cannabigerol (CBG), Nonpsychotropic Cannabinoids, as Analgesics that Effectively Manage Bone Read more… Cannabis compounds in fracture pain relief and healing originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - October 31, 2023 Category: General Medicine Authors: Tags: Meds Pain Management Source Type: blogs

Rube Goldberg Would Be Proud
By KIM BELLARD Larry Levitt and Drew Altman have an op-ed in JAMA Network with the can’t-argue-with-that title Complexity in the US Health Care System Is the Enemy of Access and Affordability. It draws on a June 2023 Kaiser Family Foundation survey about consumer experiences with their health insurance. Long stories short: although – surprisingly – over 80% of insured adults rate their health insurance as “good” or “excellent,” most admit they have difficulty both understanding and using it. And the people in fair or poor health, who presumably use health care more, have more problems. Health insurance...
Source: The Health Care Blog - October 31, 2023 Category: Consumer Health News Authors: matthew holt Tags: Health Policy Employers Health system change Kim Bellard Medicare PBMs Source Type: blogs

Faculty Perspectives on Responding to Microaggressions Targeting Clerkship Students
On this episode of the Academic Medicine Podcast, Meghan O’Brien, MD, MBE, and Research in Medical Education (RIME) Committee members Tasha Wyatt, PhD, and Javeed Sukhera, MD, PhD, join host Toni Gallo to discuss new research into faculty perspectives on responding to microaggressions targeting medical students in the clinical learning environment. They explore several tensions that affected how faculty responded to the microaggressions in the study scenarios as well as some of the strategies the faculty used to respond effectively. This episode is now available through Apple Podcasts, Spotify, and anywhere else p...
Source: Academic Medicine Blog - October 31, 2023 Category: Universities & Medical Training Authors: amrounds Tags: AM Podcast AM Podcast Transcript Academic Medicine podcast faculty development medical education medical students microaggressions RIME Source Type: blogs

Medicare and Social Security
Since it was a Krugzilla column about the Republican plan to drastically cut Medicare and Social Security benefits, I ' ll let the Krug answer the people who say " But we have to cut these programs, we can ' t afford them, what are the Democrats going to do about it? "Here ' s your gift link. By all means do read, but let me summarize the main points. First, regarding Social Security, the rise in cost resulting from the Baby Boomers retiring and the general aging of the population will actually be pretty modest, from about 4.9% of GDP today to 6.4% in 2052, according to CBO projections. And that ' s assuming that life...
Source: Stayin' Alive - October 30, 2023 Category: American Health Source Type: blogs

" Non-STEMI " is a worthless term.
A 60 yo with 2 previous inferior (RCA) STEMIs, stented, called 911 for one hour of chest pain. He had no h/o heart failure. Here is the first prehospital ECG (time 0, after one hour of pain): I do not see evidence of OMI, and neither did the Queen of HeartsHere is the 2nd prehospital ECG (time 10 minutes, after 70 minutes of pain): No changeOn arrival, the first ED ECG was recorded 20 minutes after the last one (90 minutes after pain onset): What do you think?Here is his most recent previous ECG:This was recorded after intervention for inferior STEMI (with massive ST Elevation, see below), and shows inf...
Source: Dr. Smith's ECG Blog - October 30, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs

Surgeon suicides: Unveiling a silent crisis
When I read The Guardian article, “US surgeons are killing themselves at an alarming rate. One decided to speak out,” I felt like throwing up. I’m sickened so many surgeons are dying. I’m grateful Dr. Cunningham is speaking out. I’m relieved she is alive. But I felt nauseated that Carrie Cunningham’s pain is being used to tout Read more… Surgeon suicides: Unveiling a silent crisis originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - October 28, 2023 Category: General Medicine Authors: Tags: Physician Psychiatry Source Type: blogs

Continuous prolonged generalized weakness, lightheadedness, and presyncope. What might you suspect from the ECG?
A young man presented with continuous prolonged generalized weakness, lightheadedness, and presyncope. There was some dyspnea but no chest pain.  Here is his ECG.  This shows LVH, with high voltage.LVH can have very thick-walled ventricles and a correspondingly small LV cavity.  LVH is a common etiology of heart failure with preserved ejection fraction, as it may results in a stiff ventricle with poor diastolic relaxation.See this articles: Heart Failure with Preserved Ejection Fraction (NEJM review)One etiology of LVH on the ECG is Hypertrophic Cardiolmyopathy (HOCM), and sometimes ECGs in pa...
Source: Dr. Smith's ECG Blog - October 28, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs

Opioid regulations: a patient advocate ’ s insights [PODCAST]
Subscribe to The Podcast by KevinMD. Catch up on old episodes! Join Richard A. Lawhern, a patient advocate. We delve into the critical issues surrounding U.S. policy for the regulation of prescription opioid pain relievers and the challenges faced by clinicians managing chronic pain patients. Explore the controversial CDC guidelines, the impact on both patients Read more… Opioid regulations: a patient advocate’s insights [PODCAST] originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - October 25, 2023 Category: General Medicine Authors: Tags: Podcast Pain Management Source Type: blogs

A man in his 60s with syncope and ST depression. What does the ECG mean?
Written by Sean Trostel MD, peer reviewed by Meyers, Smith, Grauer, etc.A man in his 60s with a history of severe alcohol use disorder and epidural abscess on long-term ciprofloxacin presented to the emergency department after an episode of syncope while standing in line at a grocery store.He did not have chest pain.Here is his triage ECG:   What do you think?My interpretation:Sinus rhythm, normal QRS, widespread wavy ST depression leading into late T/U-waves with very prolonged QT. No evidence of OMI. QTc/QUc is in the range of 630 msec.What is the most likely cause of the patient ’s ECG findings, and wha...
Source: Dr. Smith's ECG Blog - October 25, 2023 Category: Cardiology Authors: Pendell Source Type: blogs

Rethinking U.S. opioid policy
I write widely as a subject matter expert on U.S. policy for the regulation of prescription opioid pain relievers and of clinicians who employ them in managing their patients’ chronic pain. Because I am a patient advocate and the spouse of a chronic pain patient, I hear from a lot of suffering people. In one form Read more… Rethinking U.S. opioid policy originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - October 24, 2023 Category: General Medicine Authors: Tags: Conditions Pain Management Source Type: blogs

Sunday Sermonette: Yet another blowhard
It seems that four endless yammerers isn ' t enough. Now we get a fifth. Elihu runs his mouth for the next six chapters and says approximately nothing. He spends the first chapter just blathering about how he is about to speak. Then he says that Job is wrong to claim he hasn ' t done anything to deserve his fate, but the other three Bozos are losers because they haven ' t been able to prove that he ' s wrong. But then Elihu spends the next four chapters equally failing to prove anything and just spewing more endless dreck about the greatness of God. This book could easily be one twentieth as long, probably a lot less, and ...
Source: Stayin' Alive - October 22, 2023 Category: American Health Source Type: blogs

When a breast lump is as scary as Halloween
October is an important month for many, but I’m not actually talking about Halloween. However, for many, it can be a reminder of something very scary that happened in their lifetime. For me, it isn’t October, a month dedicated to breast cancer awareness. March was when breast pain and a self-detected lump would lead me Read more… When a breast lump is as scary as Halloween originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - October 21, 2023 Category: General Medicine Authors: Tags: Conditions Oncology/Hematology Source Type: blogs